It began with vomiting and diarrhea...

It's not the stomach flu 

The CDC estimates that 21 millions cases of acute gastroenteritis are due to norovirus infections each year. Lay people and health care providers often erroneously call norovirus "the stomach flu" or "the 24 hour flu". However, this is misleading and confusing to patients, because the flu is caused by influenza, a vaccine-preventable respiratory virus that does not typically cause vomiting and diarrhea.  Noroviruses are single-stranded RNA, non-enveloped viruses in the caliciviridae family. The illness is characterized by abrupt onset of vomiting and/or watery (non-bloody) diarrhea, stomach cramps, fever, myalgias (muscle aches), and malaise. The incubation period is typically 24 to 48 hours, but can be as short as 12 hours; the illness typically lasts 24 to 72 hours.  Complications are rare, but young children and the elderly are at increased risk of severe dehydration. Treatment is supportive. Immunity to norovirus may last only a few months and may be strain specific. More than 25 different genotypes of norovirus are known to infect humans.

Viral shedding begins with onset of symptoms and can continue for several weeks. Therefore, persons with confirmed or suspected norovirus infection should not work as food handlers or health care workers until at least 48 hours after recovery from both vomiting and diarrhea.  Transmission of norovirus is primarily via the fecal-oral route, though transmission through aerosolized virus particles from vomiting has been described. Health care providers and others who might be exposed to emesis from a person with suspected norovirus should wear a mask, gloves, and gown. Ingestion of as few as 10 virus particles has been shown to cause infection.

Cleaning and Disinfecting

A relatively strong (1:50) bleach solution (1/3 cup in 1 gallon of water) is necessary to disinfect contaminated non-porous surfaces. Because it is caustic, be sure to wear gloves and eye protection when preparing and using bleach solution. For surfaces that cannot be disinfected with bleach, a variety of products have been approved as effective against norovirus by the Environmental Protection Agency, and can be found here:

www.epa.gov/oppad001/list_g_norovirus.pdf.

Diagnosis and testing

Diagnosis of norovirus is generally clinical, and laboratory confirmation is not required or useful in most cases. Some local commercial laboratories have begun offering RT-PCR testing. The Washington State Public Health Laboratory does norovirus testing at the request of local health departments to confirm foodborne outbreaks.

Winter vomiting disease

Each year Public Health receives multiple reports of gastroenteritis outbreaks in institutional settings. Outbreaks are more common during the winter months, consistent with norovirus' traditional English name, "winter vomiting disease".  As of March 15th, fifteen long-term care facilities in King County had reported outbreaks of acute gastroenteritis since the start of 2010. The average attack rate among residents was 30 percent and the average outbreak duration (among the 12 facilities where outbreaks have resolved) was 8 days (range: 4 to 12 days).

Although individual cases of norovirus infection are not reportable, health care providers and facilities should report the following to Public Health by calling 206-296-4774:

· Clusters of any illness (including suspect or confirmed norovirus infection) when source is suspected to be foodborne or waterborne.

· Outbreaks in institutional settings, such as long-term care facilities, hospitals, and schools.

For more information, please visit the Public Health website at www.kingcounty.gov/health/cd and click on "N" for norovirus.

It's time for our 1^st annual Move-a-thon!   On April 7^th, our school will be rocking and the kids will be walking (or running or dancing)!    The Move-a-thon is a pledge driven fundraiser, and will not be based on a per lap donation.  Instead the kids will be looking for "sponsors" to donate a single flat donation. Sponsors are those lovely folks who agree to donate money for a participant who is a mover in our Move-a-thon!  They may be family, friends, your neighbors, or even corporate match programs.   Each class will participate on the afternoon of April 7^th.  The toddlers will start off by "running" an obstacle course in the gym and the older children will be walking /running laps.  Parents are encouraged to join us that afternoon to run/walk with their child.   Prizes will be handed out to every child who participates, and Grand Prizes will be awarded to "Most Funds Raised" and "Most Laps Walked" in each class.

Money raised from this event will be used for our new playground equipment.  We are nearly half way there, our goal is to raise the additional $7,500 needed to purchase and install the playground!   This breaks down to $100 per family.  We are hoping for 100% participation for this event.  All donations are tax deductible.  

Be on the lookout in your parent folder for more information and sponsor donation receipts.